Findings Brief


Who Decides: Do Individual Physicians in Group Practices Have Discretion Over Acceptance of New Medicaid Patients?

Vol. IX, No. 3
November 2006

Since Medicaid is administered by states within the context of broad federal guidelines,variation in program design creates natural experiments for determining how both policy and the organization of care effects physicians’choices to treat Medicaid patients.New research examines the extent to which physicians’ have discretion over their acceptance of new Medicaid patients and the affect that this discretion has on the extent of Medicaid participation. The study was led by Phillip R. Kletke, Ph.D., formerly of the Health Research and Educational Trust.

Children in Foster and Kinship Care at Risk for Inadequate Health Care Coverage and Access

Vol. VII, No. 4
July 2004

Children who live in foster care or kinship care arrangements often lack adequate physical or mental health care, according to new research by the University of Colorado’s Stephen Berman, M.D., and Sara Carpenter, M.D. Using data from the 1997 and 1999 rounds of the National Survey of America’s Families (NSAF) representing 4.5 million children, the researchers examined the relationship between out-of-home placement and health insurance status and utilization of physical and mental health care services.

Managed Care Mandates Fall Short of Curbing California Medicaid Costs

Vol. III, No. 2
March 2005

Over the past several years, growth in Medicaid spending has far outpaced the growth in state tax revenues and now accounts for nearly 22 percent of total state government spending. Rapid health care cost increases during the 1990s led many state governments to shift Medicaid recipients into managed care plans in an effort to control costs. The conventional wisdom at the time suggested that states would save money as a result.

Health Plan Report Cards May Influence Insurers More Than Consumers

Vol. III, No. 3
April 01, 2000

In a Changes in Health Care Financing and Organization (HCFO) study, Jinnet Fowles, Ph.D., vice president of the Park Nicollet Institute for Research and Education at HealthSystem Minnesota, David Knutson, also of Health-System Minnesota, and Jon Christianson, Ph.D., professor at the University of Minnesota, examined a Minnesota-mandated report card initiative that began in 1991 and required all health plans selling policies to state employees to participate in a consumer survey-based report card.

Health Purchasing Coalitions Struggle to Gain Bargaining Clout: Small Size and Lack of Support from Health Plans are Factors

Vol. 4, No. 1
June 2000

During the health care reform debate in the early 1990s, health purchasing coalitions (HPCs) were touted by some as a “magic bullet” that would cure the many ills of the health insurance market. Other proponents of HPCs, including the Clinton administration, suggested that as part of a plan for comprehensive health care reform, HPCs could help remedy a number of problems prevalent in the small-group market, including limited choice, high insurance costs, and increasing numbers of uninsured workers.

Risk Selection in Employer-Sponsored Managed Care Plans

Vol. VIII, No. 8
September 1, 2005

In 2002, more than 63 percent of nonelderly Americans had health insurance coverage through a current employer1— 90 percent of them enrolled in a managed care plan. At one time, managed care was promoted as a cost-efficient system that restrained costs by implementing strict controls on health care utilization and services such as preventive care, disease management, care management, and other cost-saving practices. These mechanisms assumed that managed care plans could pass on savings in the form of lower premiums.

HCFO Findings Brief: Regulating the Medical Loss Ratio: Implications for the Individual Market

Vol. XIV, No. 2
April 2011

How will the minimum medical loss ratio (MLR) provisions of the Patient Protection and Affordable Care Act impact the individual market for health insurance? Jean Abraham, Ph.D, and Pinar Karaca-Mandic, Ph.D., of the University of Minnesota, sought to provide state-level estimates of the size and structure of the individual market for health insurance and to investigate the impact of the new MLR regulation.

Families with Chronic Conditions in High-Deductible Health Plans Facing Substantial Financial Burden

Vol. XIV No. 1
March 2011

Do families with chronic conditions in high-deductible health plans face greater financial burden than those in traditional plans? Alison Galbraith, M.D., of Harvard Medical School and the Harvard Pilgrim Health Care Institute, and colleagues compared 151 families in high-deductible health plans with 345 families in traditional plans. They found that families with chronic conditions in high-deductible health plans were more likely to experience financial burden than families with chronic conditions in traditional health plans. 

What is the Effect of Pay for Performance on Hospitals that Serve Poor Patients?

Vol. XIII, No. 7
December 2010

What is the effect of pay for performance on hospitals that serve poor patients? Ashish Jha, M.D., M.P.H., at the Harvard School of Public Health and his colleagues studied 251 hospitals that participated in the Premier Hospital Quality Incentive Demonstration against a national sample of 3017 hospitals. They found no evidence that financial incentives widened the gap in performance between hospitals that serve poor patients and other hospitals.

Changes in Emergency Department Access Between 2001 and 2005 Among General and Vulnerable Populations

Vol. XIII, No. 6
November 2010

As part of a HCFO funded study, Yu-Chu Shen, Ph.D., of the Naval Postgraduate School Graduate School of Business, and Renee Hsia, M.D., M.Sc., of the University of California, San Francisco, examined how geographic access to EDs, measured by driving time, changed from 2001 to 2005. The researchers further explored whether vulnerable populations were more susceptible to these changes. In addition, the researchers assessed whether other market- and area-level factors are associated with declined geographic access to the ED. 

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